Abstract
Abstract Background: Reports of mixed infections with NDMs and dermatophytes in onychomycosis are rare, possibly due to the inhibition of NDM growth during traditional culture. Objective: To determine the prevalence of mixed infections in onychomycosis using molecular identification. Methods: Molecular analyses were utilised to identify infecting organisms directly from at least two serial great toenail samples from each of the 44 subjects. Results: Mixed infections were present in 41% (18/44) of the subjects. A single co-infecting NDM was the most common mixed infection and was detected in 34% (15/44) of onychomycosis patients, with F. oxysporum present in 14% (6/44), S. brevicaulis in 9% (4/44), Acremonium spp in 2% (1/44), Aspergillus spp. in 4.5% (2/44) and Scytalidium spp. in 4.5% (2/44) of patients. Mixed infections with two NDMs were found in 7% (3/44) of the subjects. Conclusions: Mixed dermatophyte/NDM onychomycosis infections may be more prevalent than previously reported.
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